CLASSES Classes are team taught by experienced university and public school faculty and emphasize hands-on activities. Classes are interdisciplinary to allow campers to explore many aspects of science through the lens of wind science. Students will be grouped into classes by grade level. HOUSING Students are housed in Texas Tech residence halls. Each camper will have one roommate. Campers may request a roommate (not guaranteed). Students are supervised at all times by trained camp counselors. Meals are served daily in a Texas Tech dining hall. RECREATION Evenings are devoted to traditional summer fun that includes swimming, basketball, volleyball at the TTU Student Rec Center, a pizza party, a trip to Main Event and college readiness activities. REGISTRATION Tuition includes instruction, supervision, room and board, linen package, a camp t-shirt, a drawstring bag and evening recreation. Camp Tuition: $650 IMPORTANT DEADLINES ■ Registration Deadline: May 1, 2016 ■ Registrations are accepted on a first come first serve basis. ■ Because enrollment is limited, early registration is encouraged. REFUND POLICY A refund request should be made in writing and include the address of the refund recipient. No fees will be refunded after May 22, 2016. The refund-processing fee is $25. IDEAL ■ 806.742.2420 ideal@ttu.edu ■ www.ideal.ttu.edu www.facebook.com/TexasTechIdeal Generation TECH APPLICATION FORM ❏ Grades 9-12 ❏ To save resources, may we send program paperwork via email? Email address: PART A ■ Please print clearly. Student’s Name (First) Gender: ❏ M ❏ F Birth Date / / (Last) Grade in Fall 2016: Mailing Address: City: State: Zip: Name of Parent or Guardian (Mother) Home Phone ( ) Cell Phone ( ) Work Phone ( ) Name of Parent or Guardian (Father) Home Phone ( ) Cell Phone ( ) Work Phone ( ) School Currently Attending City Do you have a roommate request? (Not guaranteed — both students must request to room together) Have you participated in any of our programs before? ❏ Yes ❏ No If yes, which program (s)? Where did you hear about our program? T-shirt size: ❏ Youth Small (6-8) ❏ Youth Med (10-12) ❏ Youth Large (14-16) Adult Sizes: ❏ Small ❏ Medium ❏ Large ❏ XLarge ❏ XXLarge ❏ Other Payment ❏ $650 — Full Tuition ❏ $25 — Airport Transportation Fee (for those students travelling by air) Make your check or money order payable to Texas Tech University. Payment can be mailed or brought to Doak Hall, Suite 110 RETURN TO: IDEAL Texas Tech University P.O. Box 41008 Lubbock, TX 79409-1008 FAX to (806) 742-2396, or email to ideal@ttu.edu Generation TECH 2016 CAMPLIFE NECESSITIES: What to Bring: What NOT to Bring: Clothing for an entire week Clothing suitable for all weather conditions Clothes hangers Comfortable walking shoes Undergarments for an entire week Sweater or light jacket Camera Class supplies (pen, pencils, notebook) Pillow and Blanket Bathroom towels & washcloths Snacks Hair products (i.e. shampoo, conditioner, hairspray) Toiletries (i.e. makeup, sunscreen, deodorant, body wash) Toothbrush/toothpaste Alarm clock Money for incidentals Appropriate swim wear (cotton not allowed in TTU leisure pool) Sheets, pillow covers, comforter Any necessary medications (medications will be under the care of the camp supervisor) Alcohol and alcohol paraphernalia Halogen Lamps Toasters/toaster ovens/hot plates/open coiled appliances Pets Weapons Pellet guns Candles/incense George Foreman Grills Air conditioners of any kind Extension cords Combustibles Large speakers, multiple speakers, amplifiers Wireless router - for more information, please visit the IT website (www.it.ttu.edu) Television Video Games Fuel The Future! Generation TECH APPLICATION FORM Generation TECH Travel Form Airport Transportation Fee: $25 IDEAL Staff will pick up campers from the baggage claim area and accompany campers to and from campus. If camper is considered an unaccompanied minor; staff will meet them at the gate. IDEAL Staff will call parent/guardian once the student is picked up and once all have arrived at the residence hall. IDEAL Staff will call parent/guardian once flight departs. ■ AIRPORT ARRIVAL Arrival should be between 1:00-3:45 p.m. on Sunday of the camp. Arrival Time Flight Number Airline ■ AIRPORT DEPARTURE Departure should be between 11:00 a.m. and 2:00 p.m. on F ri da y of the camp. Departure Time Flight Number Airline Parent Contact C e l l Phone Student Cell (if applicable) Would you be interested in receiving information on upcoming dates and events? ❏ Yes ❏ No PAYMENT ❏ $650 — Full Tuition ❏ $25 — Airport Transportation Fee (for those students travelling by air) Make your check or money order payable to Texas Tech University. Payment can be mailed or brought to Doak Hall, Suite 110 RETURN TO: IDEAL Texas Tech University P.O. Box 41008 Lubbock, TX 79409-1008 FAX to (806) 742-2396 or email to ideal@ttu.edu Medical History Form Completion of the following, with a photocopy of proof of health insurance must be submitted with the application. If this poses a hardship, call 806 -742- 2420. Insurance is encouraged but will it not jeopardize participation. Student’s Name: Name of Family Physician: Physician’s Phone Number: Directions: Check any medical conditions that apply and provide detailed information on all medical concerns. All information will remain confidential. If necessary, attach a separate sheet of paper to explain your child’s medical condition or email additional information to: ideal@ttu.edu ❏ condition requiring medication ❏ allergies to food or medications ❏ current infections, viruses ❏ emotional or behavioral problems ❏ recent injuries, illness, operation ❏ impairment of sight, hearing, speech ❏ other Consent to Medical Treatment I, Parent, Managing Conservator, or Guardian of (Participant) hereby consent to any and all emergency medical treatment needed by said Minor Child as administered by a clinic or attending physician and accept responsibility for full payment of said treatment. I give my permission for this document to be photocopied for medical personnel. Signature of Parent, Managing Conservator, or Guardian Date: ■ AUTOBIOGRAPHICAL STATEMENT Required for all students applying, including past participants. Using a separate sheet of paper, please introduce yourself and why you want to attend this camp. Release and Hold Harmless Agreement I, Parent/Managing Conservator/Guardian, has (circle one) understand that the minor child, the opportunity to participate in Gen TECH, a program for students sponsored by Texas Tech University, Institute for the Development and Enrichment of Advanced Learners, Lubbock, Texas, from July 10-July 15, 2016. I hereby affirm that I desire to have my minor child participate in said program. I give my permission for my minor child to ride in public transportation or in vehicles driven by Texas Tech employees or representatives to and from designated activities. I, the undersigned, am aware of the dangers associated with travel by motor vehicle or other conveyance and the possibility of injuries or death while in transit. I understand that my minor child will participate in general classroom, educational, and camp activities during this program. I am aware of the dangers associated with such activities and the possibility of injuries or even death in such participation. In consideration of allowing my minor child to attend the above mentioned activities, I, the undersigned, do hereby release, indemnify, and hold harmless Texas Tech University, its Board of Regents, all the University’s officers, agents, and employees, and the Institute for the Development and Enrichment of Advanced Learners from any and all liability due to injuries, damage or death arising or resulting from any act or omission, express negligence or otherwise, of said Texas Tech University officers, advisors, agents, and employees and other officers or members of the Institute for the Development and Enrichment of Advanced Learners, or any other person or participant in said activities while attending the activities or while in transit to and from activities. The terms hereof shall also serve as a release and an assumption of risk for my minor child’s heirs, executor and administrator, and for all members of my child’s family and be pleaded as a bar to litigation. Jurisdiction of this matter and venue shall lie in Lubbock, Lubbock County, Texas. I, the undersigned, on behalf of my minor child agree to indemnify and hold Texas Tech University, its Board of Regents, and all the University’s officers, agents and employees harmless from and against any and all personal injury. I am above the age of eighteen (18) years and read this Release and Hold Harmless Agreement and voluntarily understand and accept its terms. ■ Signature of Parent, Managing Conservator, or Guardian ____________________________________________________ Date: ____________ Print or type name of Parent, Managing Conservator, or Guardian Parental Approval for Media Coverage/Participation I hereby give permission for the name of the minor listed above to be released to the media or for him/her to participate in any media coverage which might transpire during the course of the program and/or any future related programs. I authorize the use of the minor’s name, biography, likeness, voice and performance in the production of the program(s) and for the purpose of publicizing and promoting the program(s). I represent that I am a parent (guardian) of the minor whose name is listed above and I hereby agree to have my child participate in media coverage. ■ MY CHILD MAY PARTICIPATE IN MEDIA COVERAGE Signature of Parent, Managing Conservator, or Guardian _______________________________________________ Date: ______________ ■ MY CHILD MAY NOT PARTICIPATE IN MEDIA COVERAGE, and I do not wish his/her name released to the news media. Signature of Parent, Managing Conservator, or Guardian _______________________________________________ Date: ______________ A complete registration for Gen TECH includes: ❏ ❏ ❏ ❏ ❏ ❏ Autobiographical Statement Part A Medical History & Consent to Treat Form Release & Hold Harmless Form Media Coverage Participation Form Photocopy of Health Insurance (if applicable) ❏ Travel Form (if applicable) ❏ Email address (if applicable) If you want to stay up to date with everything IDEAL CAMPS follow us on Twitter and Instagram! Make sure you like us on Facebook too! Twitter: @TTUIDEAL Instagram: @TTUIDEAL Facebook: TEXAS TECH IDEAL From here, it’s possible. RETURN TO: IDEAL Texas Tech University P.O. Box 41008 Lubbock, TX 79409-1008 FAX to (806) 742-2396, or email to ideal@ttu.edu